Each week, The Livelong Woman explores science-backed insights on living longer, healthier, and stronger, all through a woman’s lens. This week, we’re talking about testosterone’s impact on women’s health.

Before we dive in, did you know there are different types of tickets for the upcoming Livelong Women’s Health Summit (and that you can use the code TIFFANY for $50 off any of them)? Join us to hear from experts like Dr. Stacy Sims, Dr. Jessica Shepherd, and Dr. Vonda Wright because dedicating time to your health is a true power move.

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Across every phase of a woman’s life, in puberty, pregnancy, perimenopause, and menopause, hormones are the body’s master conductors, orchestrating energy, mood, metabolism, and cognition. “Hormones are the information delivery system; without adequate hormones, the cells don't know what to do,” says Dr. Felice Gersh, a dual board-certified physician in OB/GYN and Integrative Medicine.

Hormones initiate a chain reaction, allowing peptides to pass the signal along, enzymes to accelerate the chemical process, and metabolic pathways to convert it all into the energy and functions your body depends on. According to Gersh, optimal cellular function depends on the right balance of estradiol, progesterone, thyroid hormones, testosterone, and cortisol.

While all of these hormones are vital, testosterone has suddenly taken center stage in the spotlight. But what do we really know about how it impacts women’s longevity?

Gersh notes that testosterone isn’t a “menopause hormone” that starts to wane like estrogen and progesterone. That’s because women produce testosterone not just in the ovaries but also in the adrenal glands, and by converting other hormones, like DHEA and androstenedione, into testosterone. This means production continues across our lifespan, even after menopause.

As it does in men, women’s testosterone also decreases with age though. And when we have testosterone deficiency, it can lead to a flattened mood, lower sex drive, weaker bones, and may negatively impact cardiovascular health. Gersh notes that on the positive side, testosterone can support ambition, drive, muscle building, and, as she puts it, your vibe, (aka your sex drive).

Large studies have shown that the loss of multiple hormones that occurs when both ovaries are surgically removed before menopause affects general health. Testosterone levels drop by about 25% and that’s enough for women who experience the surgery to face higher risks of chronic disease and even increased mortality. This makes one thing clear: testosterone plays a major role in women’s health, Gersh says.

This research, or lack thereof, highlights a big issue: we know far less about testosterone’s role in women than we should.

We have very limited data on testosterone and women, says Gersh. She adds that this gap has fueled overuse, especially with pellets and male-dosed products that push women into male-level ranges.

When that happens, testosterone excess can trigger issues like cystic acne, hair loss, voice deepening, and androgenic changes, exactly the effects most women do not want. Gersh also warns that some research suggests that extremely high testosterone may even interfere with how estrogen works. In some studies, adding testosterone to estrogen therapy canceled out estrogen’s positive effects on blood vessels and raised blood pressure, for example.

For Dr. Gersh, the path forward for women is to start with our core hormones first—thyroid, estradiol, and progesterone—and then address testosterone cautiously. She adds, it may take a lot of effort to find the right doctors or practitioners to work with you on getting the hormone levels right because: “You don’t want a steady state, you want rhythms… You’ve got to have the dance of the hormones.”

The better we understand that dance, the stronger our foundation will be, and the better we’ll age. That foundation matters more than any supplement, trend, or shortcut.